Community can find a solution to its own problems

[Rituu B. Nanda]

[Public Health Foundation of India (PHFI) with support from the International Initiative for Impact Evaluation (3ie) will undertake impact evaluation of Constellation’s SALT approach for  community involvement in increasing immunization coverage in three districts of Assam in India. Today the project kicked off to share and receive inputs from   government officials at an event held in Guwahati. During the meeting, Dr. Biraj Kanti Shome, Consultant, Community Processes (Regional Coordinator), Regional Resource Centre – North East States shared many stories. I am sharing one below]

This story involves around Auxiliary nurse midwife, commonly known as ANM. She is a village-level female health worker in India who works in health sub-centre. The sub-centre is a small village-level institution which provides primary health care to the village community.

Often there is a paucity of ANMs or ANMs are over-burdened with work as they have multiple responsibilities. Dr Shome works in the state of Assam. Once Mr Shome was on a community visit. The villagers approached him with a problem. They noted that the ANM  incharge of their area was an excellent professional. They  had no complaint against her but she did not visit to their village regularly as a result of which their children were not getting scheduled vaccination. The ANM preferred to sit in the sub-centre which is far from their village and she tend to give more time to the village which was closer to the sub-centre.

Responding to the villagers, Mr Shome asked them if they wanted to formally complain against the  ANM. The villagers responded that the ANM was a good worker but they wanted her to visit them regularly. Finally, they came up with a  solution that the ANM could equally divide her time between the two villages.

Dr  Shome concluded that  when a community approaches the government officials with a problem we just need to initiate a dialogue with the community. He also stressed the need for providing a space where communities can share and discuss openly. We have to help the community members find their own solutions rather then telling them what to do. The community members know their situation best and can find the most appropriate solution.